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炎症性肠病中的组织学活性和严重感染的风险:全国性研究
Karl Mårild1, Jonas Söderling2, Jordan Axelrad3
1Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg, Sweden; Department of Pediatrics, Queen Silvia Children's Hospital, Gothenburg, Sweden.
概括
在炎症性肠病 (IBD) 中的组织学炎症显著增加了严重感染的风险. 实现组织学缓解可能是减少IBD患者感染的关键.
科学领域:
- 胃肠病学 胃肠病学
- 传染病流行病学 传染病流行病学
- 临床研究 临床研究
背景情况:
- 患有炎症性肠病 (IBD) 的人面临更高的严重感染风险.
- 组织学疾病活动对IBD感染风险的影响尚不清楚.
研究的目的:
- 调查组织学疾病活动与IBD患者严重感染风险之间的关联.
- 确定组织学缓解是否可以减轻IBD感染风险.
主要方法:
- 全国55626名IBD患者 (1990-2016) 的基于人口的研究,带有纵向活检数据.
- 在瑞典国家患者登记册中通过住院诊断识别的严重感染.
- 考克斯回归分析用于估计感染的危险比 (HRs) 后组织学炎症与缓解,对共变量和药物进行调整.
主要成果:
- 组织学炎症与缓解相比,严重感染风险增加了59% (aHR,1.59;95% CI,1.48-1.72).
- 在性结肠炎 (aHR, 1.68) 和克罗恩病 (aHR, 1.59) 中观察到增加的风险.
- 败血症 (aHR, 1.66) 和机会性感染 (aHR, 1.71) 的风险增加;在各个子组中发现一致.
结论:
- 在IBD中,组织学炎症是严重感染的独立风险因素,包括败血症.
- 实现组织学缓解可能是减少IBD感染发病率的关键策略.
- 斯德哥尔摩伦理审查委员会批准的研究.
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